title: Mixed pyogenic and tuberculous liver abscess: clinical suspicion is what matters.
abstract: Tuberculosis (TB) is a rare cause of liver abscess, even in country like India where it is a very common infection. Moreover, tubercular liver abscess (TLA) is the most unusual pattern of hepatic tuberculosis. We report an unusual case of liver abscess in an immune-competent patient presenting only with weight loss. On investigation, initially it appeared pyogenic, but later turn out to be a mixed infection with tuberculosis. He responded well to antibiotic and antitubercular drugs. A mixed pyogenic and TLA is very uncommon. We conclude that, tuberculosis should be suspected in liver abscess, especially in the absence of typical features and failure to respond to antibiotics.
authors.affiliation: Department of Medicine, PGIMER & Dr Ram Manohar Lohia Hospital, New Delhi, India.
authors.forename: Rajnish
authors.initials: R
authors.lastname: Singh
authors.forename: Naveen
authors.initials: N
authors.lastname: Kumar
authors.forename: Deepak
authors.initials: D
authors.lastname: Sundriyal
authors.forename: Deepshikha
authors.initials: D
authors.lastname: Trisal
mesh_terms: D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D008100:Liver Abscess / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014386:Tuberculosis, Hepatic / Q000175:diagnosis*